LGPC Stormwater Management application LAKE GEORGE PARK COMMISSION
n, A Fort George Road, PO Box 749
Lake George, New York 12845-0749
phone 518-668-9347fax 518-668-5001
e-mail permits@Igpcstate.ny.us
website www.Igpc.state.n .us
APPLICATION FOR PERMIT FOR STORMWATER MANAGEMENT
For projects located in the Towns of Fort Ann, Dresden, Hague, Putnam and Ticonderoga
THIS APPLICATION IS FOR A
❑Major Project($200) ❑Minor Project($100)
APPLICATION FEE ENCLOSED: (check or money order only)
1. OWNER F l INDIVIDUAL —PARTNERSHIP C ASSOCIATION ❑CORPORATION Li MUNICIPALITY ❑AGENCY
NAME PHONE
MAILING ADDRESS
CITY STATE ZIP CODE
2. AGENT J SAME AS OWNER ❑PRESIDENT OR CEO I ]CONTRACTOR G ATTORNEY I J CONSULTANT l-.CONTACT
PERSON
NAME PHONE
MAILING ADDRESS
CITY STATE ZIP CODE
3. CONTRACTOR C SAME AS AGENT
NAME PHONE
MAILING ADDRESS
CITY STATE ZIP CODE
4. PROJECT LOCATION
TOWN FTICONDFROGA DRESDEN SECTION BLOCK LOT
I IFORT ANN ❑HAGUE
❑PUTNAM STREET
ZONING CLASSIFICATION PROPERTY IS PRESENTLY
VACANT PARTIALLY DEVELOPED _J DEVELOPED&OCCUPIED
IS PROPERTY PART OF A SUBDIVISION? _ No LJ Yes, name of subdivision
5. PROJECT DESCRIPTION
PROJECT
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PROJECTINVOLVES:
Earthwork/Landscaping Li Tree Clearing House Construction or Addition LL Driveway Construction
-Garage Construction -1 Detached Structure Septic System G Modification of a Stormwater Device
Other
DESCRIBE THE MAXIMUM SLOPE OF THE PROPERTY IN THE PROJECT AREA:
_i 0-5% (Level) 5-10% (Gradual slope) ❑ 10-15% (Moderate slope) Greater than 15% (Steep Slope)
PROPOSED USE C Residential (seasonal) Residential (year-round) ❑Association -i Public I I
Commercial
PROPOSED STARTING DATE PROPOSED COMPLETION DATE
IS ANY PORTION OF THIS ACTIVITY FOR WHICH A PERMIT IS SOUGHT NOW BEGUN OR COMPLETED?
- Yes i I No (if yes, please explain)
6. CALCULATIONS & CONTROLS
TOTAL AREA OF PROPERTY ACRES FT' (circle one)
TOTAL AREA OF LAND DISTURBANCE: FT' (do not include area of stormwater controls)
TOTAL AREA OF NEWLY CREATED IMPERVIOUS SURFACE: FT'
TOTAL VOLUME OF STORMWATER TO BE CONTROLLED: (see instructions)
TYPE OF STORMWATER CONTROL MEASURES TO BE USED:
HAS AN EROSION CONTROL PLAN BEEN PREPARED? -Yes, plan is attached C] No
If no, please contact your County Soil &Water Conservation District for assistance:
Warren County 623-3119, Washington County 692-2927, Essex County 962-8225
7. SITE INSPECTION
During the processing of this application Lake George Park Commission (LGPC) personnel may need to visit this
site for the purpose of inspecting, measuring and/or photographing site conditions.
I authorize Commission staff to conduct such a site inspection ❑yes ❑ no
I wish to be contacted prior to any site inspection ❑ yes ❑ no
8. CERTIFICATION
I hereby affirm that the information on this form and all attachments submitted herewith is true to the best of my
knowledge and belief. As a condition to the issuance of a permit, the applicant accepts full legal responsibility for all
damage, direct and indirect, or whatever nature, and by whomever suffered, arising out of the project described
herein and agrees to indemnify and save harmless the State from suits, actions, damages and costs of every name
and description resulting from the said project.
SIGNATURE OF OWNER (Note title if signing for a corporation or association) DATE
SIGNATURE OF AGENT (Both signatures needed only if agent will act for owner) DATE
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INCLUDE WITH THIS FORM:
❑ Application fee
❑ Site location map
❑ Project plans on 8 1/2 X 11 size paper (Submit 4 copies of any plans larger than 11 X17)
❑ Names and legal mailing addresses of any co-owners of the property
❑ Attachment A (for major projects only)
❑ Stormwater Control Report (for major projects only)
❑ Environmental Assessment Form (for major projects only)
Failure to include any one of the required items will result in an incomplete notice and delay in processing
your application. Permits and approvals maybe required from other agencies and municipalities.
LAKE GEORGE PARK COMMISSION
ATTACHMENT A
to Stormwater Management Permit Application (For Major Projects)
Permits or approvals required from other agencies or municipalities
Agency Permit or Approval Date Applied Date Issued
Adjoining Property Owners
List all parcels within 500 feet
Tax Parcel Number Name Mailing Address
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LAKE GEORGE PARK COMMISSION
Fort George Road, PO Box 749
Lake George, New York 12845-0749
phone 518-668-9347fax 518-668-5001
e-mail permits@lgpc.state.ny.us
website www.Igpc.state.n .us
STORMWATER MANAGEMENT APPLICATION INSTRUCTIONS
For projects located within the Lake George Park and within the Towns of
Ticonderoga, Dresden, Hague, Putnam and Fort Ann
A. GENERAL INFORMATION
Lake George is a State-owned resource held in custody of the people of the State and protected under several
State laws. Because the Lake has a relatively small and steep watershed, its water quality is highly
susceptible to pollution caused by stormwater runoff. Development projects, when uncontrolled, can cause
runoff problems during construction and after completion. In order to protect water quality, development
projects are required to provide for the control of stormwater runoff.
This is a general guide for those undertaking projects which may require a permit from the Lake George Park
Commission (LGPC). This is not a description of all applicable laws or regulations- other permits may be
required for your project. It is the owners responsibility to obtain all required approvals prior to commencing
work.
The Lake George Park is comprised of Lake George and, essentially, its land drainage basin. As such, the
Park includes private lands some miles from the lake. If there is a question as to whether or not the project
site is located within the Park, contact the Lake George Park Commission for a determination. If your project is
located within the Lake George Park but in the Town of Bolton, Queensbury or Lake George or the Village of
Lake George please contact the Town zoning administrator directly for applicable stormwater management
permit requirements.
B. STORMWATER MANAGEMENT PERMIT REQUIREMENTS
A permit must be obtained prior to commencing:
1. Projects involving the creation of more than 1000 square feet of impervious surface. Impervious
surfaces include buildings, pavement, blacktop, macadam, packed earth and crushed stone.
2. Land clearing, grading or filling involving more than 5000 square feet.
It is a violation of the Lake George Park Commission Stormwater Management regulations to maintain a
condition which, due to a human disturbance of land, vegetative cover, or soil, results in the erosion of soil into
any water body.
If you are not sure if you need a permit you can send a jurisdictional inquiry to us for a determination. Just
send a cover letter with your name, address, phone number and tax map number of your property asking for a
jurisdictional determination, along with a copy of your project plans. Be sure to include all proposed changes
to the property including all structures to be removed and added, driveways, sheds, decks, garages, etc.
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C. PROJECT CLASSIFICATION
Minor Projects (projects not falling into one of these categories are Major Projects):
1. Any building, land clearing or development activity affecting less than 15,000 square feet.
2. Creation of a two-lot, three-lot or four-lot subdivision which may result in the construction of no more
than one single-family residential structure and related accessory structures per lot, and will require
land clearing or alteration activities of less than 15,000 square feet per lot and less than 15.000 square
feet total for any subdivision road.
3. Any building, alteration or modification of a stormwater control measure, excluding maintenance,
cleaning or repair of such stormwater control measure.
If your project site contains any of the following conditions it may be considered as a Major Project:
1. Soils of high potential for overland or through-soil pollutant transport.
2. An area with a slope of fifteen percent (15%) or greater when measured in any direction over a
distance of one hundred (100)feet from the center of the proposed building site.
3. An area with a soil percolation rate slower than sixty (60) minutes per inch.
D. FILING YOUR APPLICATION
A pre-application meeting with Commission staff may be desirable for large or complex projects. Please
contact the Commission's Director of Engineering, Thomas Wardell, for an appointment.
A complete application must include the following:
Application form - completed and signed.
An application fee in the form of a check or money order made payable to LGPC (see application form
for fee schedule). Application fees are not refundable.
A general location map of the property sufficient to direct someone to your site.
Project plans (see below)
For major projects only:
The names and legal mailing addresses of all landowners within five hundred (500)feet of the project
site. (this information may be obtained from your town's tax assessment office).
A complete list of all permits or approvals required from other agencies, the status of each application
and the status of the action under the State Environmental Quality Review Act (SEQR).
A completed Full Environmental Assessment Form.
A Stormwater Control Report. A Stormwater Concept Plan may also be required. See regulations for
requirements
NOTE: Failure to include any one of these items will result in an incomplete notice and delay in processing
your application.
D. FILING YOUR APPLICATION (continued)
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Common mistakes to avoid
Information was omitted from the application form - the application was not signed by the owner.
Vicinity or location maps not suitable to direct someone to the site. The map should reference a
principal highway, road names,etc. Topographic maps or county highway maps are suggested.
Vague, incomplete or poor quality plans. Plans should be to scale and show all pertinent distances and
dimensions.
Incorrect mailing addresses for adjacent owners.
The application fee is omitted.
Section, block and lot number incorrectly given. This is the legal tax map number assigned to each
property.
PROJECT PLANS
The project plans are the basis for review and approval of the project and typically consist of a site plan
showing all new development and location of stormwater measures, erosion control plans and construction
details for stormwater and erosion control devices. Construction must be in strict accordance with the plans.
Applicants for minor projects should consult the Guide for Minor Projects Manual. Your local Soil &Water
Conservation District may be able to assist you in the preparation of plans.
Site Plan - Have your builder, engineer, landscaper or architect provide you with a site plan. The plan
should be an accurate drawing to scale showing property boundaries, streams, wetlands and lakes
within 100 feet of the property, existing and proposed buildings, driveways, wastewater system, wells,
patios and other hard surfaces and the areas to be cleared,filled or graded. Label all buildings as
existing or proposed and note any existing buildings to be removed.
Erosion &Sedimentation Control Plan -Show locations of all temporary erosion control devices to
be utilized during construction on a copy of the site plan. Minimize the disturbance to land by limiting
the area to be cleared, cut or filled and the time period that the site will be worked and de-stabilized.
Protect downgradient streams, lakes, wetlands with erosion control devices such as haybales, dikes,
filter fabric fencing, etc. Stock piled earthen materials should be protected. Contact your local Soil &
Water Conservation District for assistance:
Warren County 623-3119, Washington County 692-2927, Essex County 962-8225
Stormwater Control Plan -Show locations of all permanent stormwater control devices on a copy of
the site plan.
Construction Details-The stormwater control device details should include a profile view and
construction details of such devices as dry wells, infiltrators, trenches, retention ponds,trenches, etc.
(some detail drawings for typical devices are available from the Commission on request).
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E. PROCESSING YOUR APPLICATION
Applicants are generally notified within a week that their application has been received and within 15 days
whether the application is complete or additional information is required. For major projects - processing a
complete application requires certain statutory notice and review periods including notice and opportunity for
comments from adjacent owners.
For minor projects a decision should normally be made within 30 days of receipt of a complete application. For
major projects a decision should normally be made by the full Commission at the first regularly scheduled
monthly meeting following completion of any public notice period.
F. PERMITS FROM OTHER AGENCIES
Other permits or approvals for projects may be required from Federal, State, Regional or Local agencies.
Project sponsors should inquire at these agencies as to authorizations which may be necessary before
commencing work. The list of agency contacts which follows is provided to assist project sponsors. It is not
intended to mean that a permit is required from the agency, nor does the list include all agencies from which
authorization may be required.
Town Zoning Administrator NYS Department of Environmental Conservation
Wayne Wagner,Ticonderoga 585-9851
Paul Barone, Hague 543-6161 Essex County
PO Box 67
County Planning Board or Building Ray Brook, NY 12885
Department (518)891-1370
Essex 873-3685
Washington 746-2290 Warren or Washington Counties
Warren 761-6410 PO Box 220 Hudson Avenue Extension
Warrensburg, NY 12885
Adirondack Park Agency (518)623-1200
PO Box 99
Ray Brook, NY 12977
(518)891-4050
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